An endotracheal tube enters the treachea of a patient through the mouth or nose. It permits the external control of that person's breathing. The procedure provides important benefits when attaching a person, whose processes do not provide sufficient oxygen, to a respirator. It also finds use in administering a gaseous anesthetic to a patient undergoing a surgical procedure.
Typically, the endotracheal device includes a tube of semiflexible plastic shaped at one end to facilitate its insertion into the trachea. The other end couples to an adaptor with a press-fit coupling. The adaptor represents a piece of substantially rigid plastic which can connect to the mechanical respirating equipment.
To retain the endotracheal device in place, the tube usually includes an inflatable collar around the end inserted in the trachea. Once positioned in the trachea, the collar undergoes inflation to secure it against the tracheal wall. This helps to prevent its dislodgement from the desired location, and provides an airtight system.
Furthermore, the attendant generally places adhesive tape around the end of the device remaining extended from the patient's mouth. The tape wraps around the tube and then adheres to the patient's facial skin. The tape retains the tube in the proper position relative to the patient.
However, while intubated, the patient continues to salivate. These liquids, or "juices", flow up and around the tube and contact the adhesive tape. This fluid can then dislodge the tape from the tube, the adaptor, and the patient's face. Any benefit originally received from the tape becomes lost through this process. Moreover, the saliva can actually attack the press fit between the tube and the adaptor. Eventually, the adaptor, with its connection to the mechanical respirator, can dislodge from the plastic tube. The patient then loses, even if only temporarily, the assistance to his breathing or the anesthetic that he should receive.
Even while adhering, the tape itself causes additional problems. Many people have a mild to severe allergy to the tape's adhesive. Most hospitals, of course, do use, when necessary, a hypoallergenic tape. However, the need for such a tape for any particular individual does not become apparent until that patient has shown some reaction to the usual adhesive. By that time, the patient may have already developed significant dermatological problems.
Thus, although endotracheal tubes have provided definite advantages to patients undergoing surgery and when in need of respiratory assistance, the device needs constant attention. Additionally, a disoriented patient, while on a respirator, may himself dislodge the endotracheal tube. These problems become even more serious since the dislodgement and subsequent movement of the tube can traumatize a patient's vocal cords and trachea. Consequently, the effort continues to find an endotracheal device providing greater reliability and safety for the patient.